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Adult Medical-Surgical Proctored Assessment |
Advanced/Hard Difficulty | Comprehensive Exam
Bank |200 questions and verified answers- 100%
Pass Guaranteed | Graded A+
Question 1
A nurse is caring for a client who has been admitted with a diagnosis of
acute myocardial infarction. Which of the following laboratory findings is
most specific for confirming this diagnosis?
A. Elevated creatine kinase-MB (CK-MB)
B. Elevated troponin I
C. Elevated myoglobin
D. Elevated lactate dehydrogenase (LDH)
Valid answer: B
Explanation: Troponin I is the most specific and sensitive cardiac
biomarker for myocardial infarction. It rises within 3-4 hours and remains
elevated for up to 14 days. CK-MB is specific but less sensitive and
returns to normal faster than troponin. Myoglobin is early but nonspecific.
LDH is an older marker less specific for cardiac injury.
Question 2
A nurse is assessing a client with suspected heart failure. Which of the
following findings is an early manifestation of left-sided heart failure?
A. Jugular vein distention
B. Peripheral edema
C. Crackles in the lung bases
D. Hepatomegaly
Valid answer: C
Explanation: Crackles in the lung bases indicate pulmonary congestion and
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are an early sign of left-sided heart failure. Jugular vein distention,
peripheral edema, and hepatomegaly are signs of right-sided heart
failure.
Question 3
A client with chronic obstructive pulmonary disease (COPD) is receiving
oxygen therapy at 2 L/min via nasal cannula. The nurse notes that the
client's respiratory rate has decreased to 10 breaths/min. Which of the
following actions should the nurse take first?
A. Increase the oxygen flow rate to 4 L/min
B. Assess the client's level of consciousness
C. Notify the provider
D. Prepare for mechanical ventilation
Valid answer: B
Explanation: The nurse should first assess the client's level of
consciousness to determine the severity of respiratory depression. Clients
with COPD may have a hypoxic drive, and high oxygen concentrations
can suppress their respiratory drive. Increasing the oxygen f low rate is
contraindicated. Notifying the provider and preparing for ventilation
follow after assessment.
Question 4
A nurse is providing teaching to a client with type 1 diabetes mellitus.
The client asks about signs of hypoglycemia. Which of the following
symptoms should the nurse include in the teaching?
A. Polyuria and polydipsia
B. Fruity breath odor
C. Diaphoresis and tremors
D. Weight loss and fatigue
Valid answer: C
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Explanation: Diaphoresis (sweating) and tremors are symptoms of
hypoglycemia due to sympathetic nervous system activation. Polyuria and
polydipsia are symptoms of hyperglycemia. Fruity breath odor indicates
diabetic ketoacidosis. Weight loss and fatigue are symptoms of
uncontrolled hyperglycemia.
Question 5
A nurse is caring for a client who is 6 hours post-operative following a
total hip arthroplasty. Which of the following interventions is the priority
for preventing deep vein thrombosis (DVT)?
A. Administer prophylactic anticoagulants
B. Perform passive range-of-motion exercises
C. Apply sequential compression devices
D. Encourage early ambulation
Valid answer: D
Explanation: Early ambulation is the most effective intervention for
preventing DVT as it promotes venous return and prevents stasis. While
anticoagulants, sequential compression devices, and passive range-of-
motion exercises are also important, early ambulation is the priority
intervention.
Question 6
A nurse is caring for a client who has a new prescription for enoxaparin.
Which of the following adverse effects should the nurse monitor for?
A. Thrombocytopenia
B. Hyperkalemia
C. Hypertension
D. Bradycardia
Valid answer: A
Explanation: Enoxaparin, a low-molecular-weight heparin, can cause
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heparin-induced thrombocytopenia (HIT). The nurse should monitor the
platelet count. Hyperkalemia, hypertension, and bradycardia are not
common adverse effects of enoxaparin.
Question 7
A nurse is caring for a client with cirrhosis of the liver. Which of the
following manifestations should the nurse expect to find?
A. Spider angiomas
B. Polyuria
C. Jaundice and ascites
D. A and C
Valid answer: D
Explanation: Cirrhosis is characterized by spider angiomas, jaundice, and
ascites due to portal hypertension and impaired liver function. Polyuria is
not a typical finding in cirrhosis.
Question 8
A nurse is assessing a client with acute pancreatitis. Which of the
following findings should the nurse expect?
A. Pain that radiates to the right shoulder
B. Pain that is relieved by food
C. Left upper quadrant or epigastric pain
D. Hyperactive bowel sounds
Valid answer: C
Explanation: Acute pancreatitis typically presents with left upper
quadrant or epigastric pain that may radiate to the back. Pain radiating
to the right shoulder is associated with cholecystitis. Pain that is relieved
by food is associated with peptic ulcer disease. Bowel sounds are usually
hypoactive in pancreatitis.
Adult Medical-Surgical Proctored Assessment |
Advanced/Hard Difficulty | Comprehensive Exam
Bank |200 questions and verified answers- 100%
Pass Guaranteed | Graded A+
Question 1
A nurse is caring for a client who has been admitted with a diagnosis of
acute myocardial infarction. Which of the following laboratory findings is
most specific for confirming this diagnosis?
A. Elevated creatine kinase-MB (CK-MB)
B. Elevated troponin I
C. Elevated myoglobin
D. Elevated lactate dehydrogenase (LDH)
Valid answer: B
Explanation: Troponin I is the most specific and sensitive cardiac
biomarker for myocardial infarction. It rises within 3-4 hours and remains
elevated for up to 14 days. CK-MB is specific but less sensitive and
returns to normal faster than troponin. Myoglobin is early but nonspecific.
LDH is an older marker less specific for cardiac injury.
Question 2
A nurse is assessing a client with suspected heart failure. Which of the
following findings is an early manifestation of left-sided heart failure?
A. Jugular vein distention
B. Peripheral edema
C. Crackles in the lung bases
D. Hepatomegaly
Valid answer: C
Explanation: Crackles in the lung bases indicate pulmonary congestion and
, 2
are an early sign of left-sided heart failure. Jugular vein distention,
peripheral edema, and hepatomegaly are signs of right-sided heart
failure.
Question 3
A client with chronic obstructive pulmonary disease (COPD) is receiving
oxygen therapy at 2 L/min via nasal cannula. The nurse notes that the
client's respiratory rate has decreased to 10 breaths/min. Which of the
following actions should the nurse take first?
A. Increase the oxygen flow rate to 4 L/min
B. Assess the client's level of consciousness
C. Notify the provider
D. Prepare for mechanical ventilation
Valid answer: B
Explanation: The nurse should first assess the client's level of
consciousness to determine the severity of respiratory depression. Clients
with COPD may have a hypoxic drive, and high oxygen concentrations
can suppress their respiratory drive. Increasing the oxygen f low rate is
contraindicated. Notifying the provider and preparing for ventilation
follow after assessment.
Question 4
A nurse is providing teaching to a client with type 1 diabetes mellitus.
The client asks about signs of hypoglycemia. Which of the following
symptoms should the nurse include in the teaching?
A. Polyuria and polydipsia
B. Fruity breath odor
C. Diaphoresis and tremors
D. Weight loss and fatigue
Valid answer: C
, 3
Explanation: Diaphoresis (sweating) and tremors are symptoms of
hypoglycemia due to sympathetic nervous system activation. Polyuria and
polydipsia are symptoms of hyperglycemia. Fruity breath odor indicates
diabetic ketoacidosis. Weight loss and fatigue are symptoms of
uncontrolled hyperglycemia.
Question 5
A nurse is caring for a client who is 6 hours post-operative following a
total hip arthroplasty. Which of the following interventions is the priority
for preventing deep vein thrombosis (DVT)?
A. Administer prophylactic anticoagulants
B. Perform passive range-of-motion exercises
C. Apply sequential compression devices
D. Encourage early ambulation
Valid answer: D
Explanation: Early ambulation is the most effective intervention for
preventing DVT as it promotes venous return and prevents stasis. While
anticoagulants, sequential compression devices, and passive range-of-
motion exercises are also important, early ambulation is the priority
intervention.
Question 6
A nurse is caring for a client who has a new prescription for enoxaparin.
Which of the following adverse effects should the nurse monitor for?
A. Thrombocytopenia
B. Hyperkalemia
C. Hypertension
D. Bradycardia
Valid answer: A
Explanation: Enoxaparin, a low-molecular-weight heparin, can cause
, 4
heparin-induced thrombocytopenia (HIT). The nurse should monitor the
platelet count. Hyperkalemia, hypertension, and bradycardia are not
common adverse effects of enoxaparin.
Question 7
A nurse is caring for a client with cirrhosis of the liver. Which of the
following manifestations should the nurse expect to find?
A. Spider angiomas
B. Polyuria
C. Jaundice and ascites
D. A and C
Valid answer: D
Explanation: Cirrhosis is characterized by spider angiomas, jaundice, and
ascites due to portal hypertension and impaired liver function. Polyuria is
not a typical finding in cirrhosis.
Question 8
A nurse is assessing a client with acute pancreatitis. Which of the
following findings should the nurse expect?
A. Pain that radiates to the right shoulder
B. Pain that is relieved by food
C. Left upper quadrant or epigastric pain
D. Hyperactive bowel sounds
Valid answer: C
Explanation: Acute pancreatitis typically presents with left upper
quadrant or epigastric pain that may radiate to the back. Pain radiating
to the right shoulder is associated with cholecystitis. Pain that is relieved
by food is associated with peptic ulcer disease. Bowel sounds are usually
hypoactive in pancreatitis.
